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General NPI Number Information
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NPI Number | 1801203534
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Entity Type | Individual
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Provider Name | JEAN RICK DUROSEAU
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Gender | Male
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Dates
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Enumeration Date | 07/15/2014
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Last Update Date | 07/12/2023
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Provider Practice Location Address
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Address Line | 3510 4TH ST
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City | LUBBOCK
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State | TX
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Zip | 79415-3329
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Country | US
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Telephone | 806-472-3420
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Fax |
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Provider Business Mailing Address
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Address Line | 1703 KIRBY AVE
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City | LUBBOCK
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State | TX
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Zip | 79416-6138
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Country | US
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Telephone | 954-756-5923
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP127354
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 66489
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9302212
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 66489
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License Number State | NM
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9302212
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License Number State | FL
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